Diagnosing ADHD in children

Diagnosing ADHD and ADD in children is often complicated as the symptoms can be indicative of another condition. Finding a clinician with experience of diagnosing ADHD is really important to ensuring your child has the right treatment plan in place.

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Is an ADHD assessment right for my child?

The symptoms and signs of ADHD can vary hugely between children. Some children show classic signs of hyperactivity, other children appear to be quite calm but struggle immensely to pay attention and stay focussed on a task or at school.Other conditions such as dyslexia, thyroid dysfunction, behavioural issues and mood disorders can also cause some of the common symptoms and signs of ADHD.

These factors can make it hard for parents to know whether their child has ADHD or something else. It can be a very worrying and frustrating time when you suspect that something is different about your child – perhaps school are telling you your child is behaving in different ways to other children, but yet it isn’t clear what help they need and who is best suited to provide that help.

Your GP or a mental health professional, such as a Psychiatrist is the best place to start for any parent unsure if their child has ADHD. A child and adolescent Psychiatrist will see hundreds of children every year who do have ADHD and will be able to rule a diagnosis in, or out and make recommendations for further assessments and treatment.

Whilst it’s natural to feel concerned or worried if you think your child is experiencing difficulties, we speak to hundreds of families every year who say that receiving some expert help for their child was a huge relief – suddenly they have a way of understanding what was causing their child’s difficulties and effective support can be put in place to help both within the home and school environments.

The importance of early diagnosis

Children with ADHD often get labelled, unfairly, as being naughty, trouble makers or daydreamers. Often their behaviours can be extremely exasperating for parents and teachers and the child may experience very little praise and a great deal of ‘telling off’. Whilst it’s understandable that these children’s behaviours will be difficult for adults to manage and tolerate, constantly being told off or being told you are somehow failing, can be hugely detrimental to a child’s self-confidence and self-esteem. A child may hear that they are ‘a naughty child’ and therefore learn that that is what is expected from them or may hear that they are ‘ditzy’ or forgetful and learn to believe that expectations are very low for them.

ADHD assessment at Clinical Partners

Robust and comprehensive assessment of ADHD is key – the condition is considered to be ‘lifelong’ and pervasive, so making sure you see an expert in the field is crucial to understanding the right treatment that will work for your child.

Before your appointment:

You and your child’s school will be sent a full range of questionnaires and psychometrics, all evidence based and proven to accurately diagnose ADHD. This information gathering is a crucial step in the diagnostic procedure – often parents are surprised by how much depth our clinicians go into, however it is key to making sure that the right diagnosis is given. If your child is old enough we will also ask them to complete some forms, our clinicians will want to know how your child feels about any difficulties they are experiencing.

During your assessment:

You and your child will meet with a senior Psychiatrist for around 2 hours. The clinician will have a great deal of experience of diagnosing ADHD and will also be looking at whether there are any other conditions that would better explain the symptoms you are concerned about. Diagnosing ‘co-morbidities’ (other mental health conditions such as depression or anxiety) is a key part to the assessment and the clinician will include any diagnoses or further actions needed in their report.

You will be asked lots of questions about your child and their development. You may want to take some notes of areas of concern or key milestones for your child.

This face to face time can be an important step to the assessment, allowing the clinicians to see how your child interacts with others.

Where possible, the clinician may be able to tell you in the appointment whether your child has ADHD (sometimes this isn’t possible, for instance if they don’t have all the information they need from schools for example). They will discuss treatment recommendations with you and advise you on next steps.

Following your assessment:

You will receive a full and comprehensive report which details the diagnosis, where one can be made, any further assessments recommended for your child and recommended treatment plans.

A lot of parents wish to return to the NHS for medication, if this treatment plan is advised. We always ask parents to discuss the options available to them with their local GP before seeking a private assessment. ADHD medications are ‘controlled’ drugs and only those with specialist training are able to initiate them – it may be that you will need to continue to see the Psychiatrist privately until the medication is stabilised, before your GP is able to take over prescribing. Not all GPs are happy to continue prescribing, so again, we always advise discussing this before commencing treatment.

We could not have had a better psychiatrist for our son, he was outstanding and his report really has made a huge difference to our son at school, at home and with his friends.

Tabitha, Bristol

Long term outcomes for children with ADHD

About 30%1 of all children with ADHD will go on to experience ADHD in adulthood. Adult ADHD can be effectively managed and many with the condition lead successful, fulfilling lives. Without diagnosis and effective management, the risk of serious conditions such as depression, difficulties holding down relationships and employment, criminal behaviour and substance abuse are increased.

Understanding the different sub-groups of ADHD allows us not only to identify children who are highly restless and overactive, but also the ones who are perhaps in a forgotten group, the ones who appear to daydream at school and struggle with task completion, and are rarely picked up because they seldom present with behavioural difficulties.

Dr Partha Banerjea is a very senior and experienced Consultant Child & Adolescent Psychiatrist. He is currently the Lead clinician for Southwark CAMHS, and has for the last 15 years managed a specialist outpatient adolescent service. This is a...

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